Even as some parts of Europe are beginning to wind down containment measures, the effects of quarantine and self-isolation on mental health are continuing to draw concern.
In addition to the elevated levels of stress and worry, health authorities are raising awareness of the added impact that the COVID-19 outbreak could have on citizens' psychology.
The World Health Organization says "levels of loneliness, depression, harmful alcohol and drug use, and self-harm or suicidal behaviour" are expected to have risen due to a disruption in normal life activity.
Older adults, care providers and people with underlying health conditions are groups of particular concern, as well as frontline health workers.
In areas heavily affected by coronavirus, citizens have limited access to services; this can impact mental wellbeing.
"It is a very difficult time, particularly for people that have young families, or vulnerable adults to care for and the uncertainty around the situation is certainly not helping".
So what are the protocols for tackling mental health?
The WHO Regional Office for Europe says that mental disorders are "one of the top public health challenges" in the region, affecting around 25% of the population every year.
During the COVID-19 pandemic, the WHO says that they have worked with national authorities to develop "a set of new materials" on supporting mental health.
"Psychosocial support services should be in place, and child protection services need to adapt to ensure that the care is still available for the children of families who need it," says the WHO.
Through the European Action Plan, the WHO had recommended that governments develop "community-based" mental health services by 2020.
This strategy would seek to avoid over-reliance on large public facilities and provide balance and investment to specific professionals in the field.
Actions that European countries have been encouraged to support include:
- Establishing primary care as a first point of access to treat common mental disorders
- Offering special outreach programmes in areas with a high prevalence of risk, such as poor minority groups or homeless people;
- Developing psychiatric units, which are therapeutic, to offer effective care
- Ensuring forensic mental health services are managed by specially trained services
- Removing obstacles to accessing care for mental health e.g. transport, finances
Back in March, the WHO Department of Mental Health and Substance Use also issued a series of recommendations for citizens to cope with mental health during the pandemic.
The advice included minimising exposure to news about COVID-19 and offering support to those in need in the local community.
But the World Health Organization does say that some authorities in Europe were struggling to implement the strategies listed in the European Action Plan.
Meanwhile, there are additional concerns that the drain of healthcare resources due to COVID-19 may be restricting necessary investment to mental health facilities.
Jennifer Oroilidis, of Mental Health Europe says that some public authorities had closed healthcare services during the pandemic "due to a lack of focus on social care".
"Public authorities must take urgent measures to protect their well-being and to ensure access to vital services during this time of crisis".
"Without immediate intervention, the consequences of the current inaction by governments will lead to a long-term negative impact on economies and communities, while leaving thousands of people experiencing mental health distress without the care they so urgently need.
Ending lockdown could be another factor
Even the prospect of the lockdown ending may not bring relief for many; mental health experts are noticing an emerging phenomenon concerned with anxiety about life after lockdown.
Dave Smithson, Operations Director at Anxiety UK, says the prospect of a second dramatic change to the "new normal" is difficult for many people whose mental health has already suffered:
"We had a survey of our members at the weekend ahead of the Prime Minister’s announcement and 67% of them reported an increase in their anxiety levels at the prospect of the easing of the restrictions.
"Of those, the biggest fear was of contracting the virus: 57% cited that as their biggest concern.
"We need to give people time and space to get used to returning to normal after being inside after such a long time.
"It’s obviously going to feel really strange and be challenging for people to return to their pre-pandemic routine. This is to be expected, especially for those with pre-existing anxiety disorders."
Smithson concludes that proper support for people disturbed by this next approaching upheaval is essential:
"As we release these restrictions and we let people return to normal, we must make additional support available for that group of people."